Individual provider Active NPI

Miranda Macfarlane, PHARMD

  • Pharmacist
  • Mishawaka, IN
National Provider Identifier
1053872242
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
390200000X Issued in IN
Practice address
611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468
Phone
(574) 335-5000
NPI assigned
Mar 29, 2019
Last updated
May 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 390200000X IN Primary

Addresses

Primary practice location

611 E Douglas Rd Ste 407
Mishawaka, IN 46545-1468

Mailing address

6409 W 126TH Ave
Crown Point, IN 46307-8777
Phone (219) 765-5254

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Miranda.Macfarlane@directsjrmc.mhin.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
390200000XINMDOtolaryngology Physician

Interoperability endpoints

  • Direct secure messaging: miranda.macfarlane@directsjrmc.mhin.net

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1053872242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 W 126TH AVE",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078777",
            "telephone_number": "219-765-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD STE 407",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451468",
            "telephone_number": "574-335-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACFARLANE",
        "first_name": "MIRANDA",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Miranda.Macfarlane@directsjrmc.mhin.net",
            "affiliation": "N",
            "endpointDescription": "Saint Joseph Mishawaka Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDC",
            "address_1": "611 E Douglas Rd Ste 407",
            "city": "Mishawaka",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465451468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.